Modulation of wound healing during and after glaucoma surgery.
Following all types of glaucoma filtration surgery (GFS), scarring still poses the major threat to long-term success. The healing and scarring determine the percentage of patients achieving low final intraocular pressures (IOPs) that are associated with virtually no glaucoma progression. The use of antifibrotic agents to inhibit scarring of trabeculectomy blebs is now a well-established clinical practice. Unfortunately, severe complications such as leakage, infection, hypotony, and endophthalmitis with complete loss of vision may occur. In addition, surgery still fails in some individuals despite maximal doses of current antifibrotics. Better therapeutic agents are needed. Many promising new agents are being evaluated clinically and in vitro. In this chapter, we will discuss our current understanding of the wound healing process after glaucoma surgery and promising new treatment modalities.
Georgoulas
Stelios
S
Ocular Repair and Regeneration Biology Research Unit, National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 9EL, UK.
Dahlmann-Noor
Annegret
A
Brocchini
Stephen
S
Khaw
Peng Tee
PT
D000903:Antibiotics, Antineoplastic / Q000494:pharmacology; D002921:Cicatrix / Q000188:drug therapy / Q000517:prevention & control; D050091:Dendrimers / Q000737:chemistry / Q000627:therapeutic use; D005347:Fibroblasts / Q000187:drug effects; D018463:Filtering Surgery / Q000009:adverse effects / Q000379:methods; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007155:Immunologic Factors / Q000737:chemistry / Q000627:therapeutic use; D007249:Inflammation / Q000188:drug therapy; D007429:Intraocular Pressure; D016685:Mitomycin / Q000494:pharmacology; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D012038:Regeneration; D014130:Trabeculectomy / Q000009:adverse effects / Q000379:methods; D014945:Wound Healing
D000903:Antibiotics, Antineoplastic; D050091:Dendrimers; D007155:Immunologic Factors; D016685:Mitomycin